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Vol. 20. Issue 1.
Pages 37-41 (January - June 2019)
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Vol. 20. Issue 1.
Pages 37-41 (January - June 2019)
Review article
DOI: 10.1016/j.vacune.2018.10.002
The sublingual influenza vaccine
La vacuna sublingual de la gripe
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J. Reina
Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Facultad de Medicina, Universitat Illes Balears, Palma de Mallorca, Baleares, Spain
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Table 1. Mucosal vaccines approved for human application.
Table 2. Future challenges for the development of sublingual influenza vaccines.
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Abstract

From the studies on the innate and adaptive immune response of the oral mucosa, experiments have been initiated on the use of the sublingual route in the administration, absorption and immunization of a vaccine against the human influenza virus. Unlike intranasal administration, the sublingual route is effective and safe and does not redirect the antigen or adjuvant to the central nervous system. The first studies conducted with soluble proteins from the influenza A virus associated with an adjuvant showed that they induced a broad and intense immune response in all mucous membranes and extramucosal tissues, including the production of secretory (IgA-s) and non-secretory (IgG) antibodies, systemic immunity and response in specific cytotoxic T lymphocytes (Th1 and Th2). Different studies have shown that the sublingual immune response is equally effective if other antigenic presentations are used (M2 protein, recombinant vectors or attenuated virus). The ease of administration by this route, either in its liquid presentation or in tablets, would facilitate the acceptability and adhesion of the population, especially children, to the vaccination of the entire population against influenza.

Keywords:
Influenza vaccine
Sublingual route
Effectiveness
Resumen

A partir de los estudios sobre la respuesta inmunitaria innata y adaptativa de la mucosa oral se han iniciado experimentos sobre la utilización de la ruta sublingual en la administración, absorción e inmunización de una vacuna frente al virus humano de la gripe. A diferencia de la administración intranasal, la ruta sublingual es eficaz y segura, y no redirecciona el antígeno o el adyuvante al sistema nervioso central. Los primeros estudios realizados con proteínas solubles procedentes del virus gripal A asociadas a un adyuvante demostraron que inducían una amplia e intensa respuesta inmunitaria en todas las mucosas y tejidos extramucosales, incluyendo la producción de anticuerpos secretores (IgA-s) y no secretores (IgG), inmunidad sistémica y respuesta en linfocitos T citotóxicos específicos (Th1 y Th2). Los diferentes estudios han comprobado que la respuesta inmunitaria sublingual es igual de eficaz si se utilizan otras presentaciones antigénicas (proteína M2, vectores recombinantes o virus atenuado). La facilidad de administración por esta ruta, ya sea en su presentación líquida como en tabletas, facilitaría la aceptabilidad y la adhesión de la población, especialmente la infantil, a la vacunación de toda la población frente a la gripe.

Palabras clave:
Vacuna gripe
Vía sublingual
Efectividad

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